AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 20 Submission ID: 1398 HEART FAILURE WITH PRESERVED EJECTION FRACTION: ASSOCIATION BETWEEN THE LEFT ATRIUM STRAIN AND THE NT-PROBNP RIDHA FEKIH, SAOUSSEN ANTIT, MARWA ABDELHEDI, KALTHOUM DRIDI, ELHEM BOUSSABEH, LILIA ZAKHAMA TUNISIA Background: Plasma concentration of NT-ProBNP is recommended as initial diagnostic test in patients with symptoms suggestive of Heart failure (HF) with preserved ejection fraction (HFpEF). The Peak atrial longitudinal strain (PALS) has been proposed as an alternative approach for left ventricular diastolic function assessment. Thus, we searched for a correlation between the PALS and the NT-ProBNP in patients with suspected HFpEF. Methods: This is a prospective descriptive study that included 67 patients with suggestive symptoms of HF, explored in the cardiology department of the hospital of the internal security forces of Marsa and having consulted between November 2021 and Mars 2022. Results: The mean age was 60±11 years, with a sex ratio of 0.76. Hypertension and obesity were the most common cardiovascular risk factors (80% and 51% respectively). Explorations objected a median NT-ProBNP of 76 mmHg [49-143] and a median PALS of 30.2 [23-32.4]. A value of NT Pro-BNP ≥125 pg/ml was found in 33% of the patients. In univariate analysis, PALS was significatively lower in patients with NT Pro-BNP ≥125 pg/ml (p= 0.02). In bivariate analysis, PALS was significatively and negatively correlated with NTPro BNP (p= 0.003, r= -0.36. The analysis of the Receiver operating characteristic curve showed that a value of PALS < 30.2 (sensibility= 63%, specificity= 77%) increases the likelihood of NT-Pro BNPI ≥125 pg/ml by 5.6 (OR= 5.6, 95% CI: 1.72-18.1). Conclusion: PALS, easily measured by echocardiography, could be used as an alternative parameter in the diagnosis of HFpEF. Keywords: Heart failure with preserved ejection fraction, NT-ProBNP, Left atrium strain. Table 1: Results of the comparative study between the two groups according to the technique of angioplasty according to ACC / AHA classification of coronary lesions. Patients have been stratified according to the stenting techniques adopted: ostial stenting (OS) or LM cross-over (CO). The primary endpoint was the occurrence of major cardiocerebrovascular events (MACCE) during the follow-up period of 12 months Results: Sixty consecutive patients (49 males, mean age 63.9±10.8 years old) have been analyzed. In CO patients the SYNTAX score (23.2±3.6 vs 17.9±4.2, p=0.04). On a mean follow-up of 11.06± 1.9 months, major adverse cardiac events (MACE) and target vessel revascularization (TVR) were 26.6%. Restenosis was higher in the OS than in CO group of patients and was located angiographically at the ostium (p =0.02). The 60 lesions of ostial LAD and associated lesions were revascularized. Two revascularization strategies were adopted: 50% (n = 30) of the patients had initially a “provisional-T-stenting” of the distal TCG bifurcation against 50% (n = 30) of patients who had ostial implantation stent with a slight protrusion in the LM bifurcation. The stenting procedure: the “float stenting technique” was associated Figure 1: Angioplasty of the ostial IVA according to the technique TCG - IVA Figure 2: Angioplasty of the ostial IVA according to the technique Floating stenting in one of our patients with a higher MACCE risk. The MACCE rate was higher with floating stenting in the order of 21.6% compared to 8.3% for cross-over stenting, with a statistically significant difference (p = 0.02). Conclusion: On long-term follow up CO appeared superior to OS technique for isolated ostial LAD disease particularly in calcified lesions. MODERATED POSTER SESSION
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